Objective To explore the value of abdominal wall lifting devices in laparoscopic cholecystectomy.Methods Patients who were going to receive laparoscopic cholecystectomy were randomly divided into two groups:one group underwent pneumoperitoneum(Gas group,n=38),the other group was treated with gasless technique using a subcutaneous abdominal wall lifting devices(Gasless group,n=37).Parameters including operation time,blood loss,real-time results of arterial blood gas analysis,postoperative hospital stay,post-operative ACTH and complications were compared between the two groups.Results The operation was completed in both the groups.There existed significant difference in the mean operation time and blood loss between the two groups [Gas group vs Gasless group:(34.2?7.7) min vs(46.7?16.8) min,t=-4.160,P=0.000 and(10.4?2.0) ml vs(14.8?7.2) ml,t=-3.627,P=0.000];whereas,no significant difference was found between the two in the real-time results of arterial blood gas analysis,postoperative hospital stay [(3.7?0.7) d vs(3.9?1.2)d,t=0.884,P=0.379] and post-operative level of ACTH(5.66 pmol/L vs 5.48 pmol/L,Z=0.748,P=0.436).No severe complications occurred in both the groups.In the gasless group,20 of the 37 patients developed subcutaneous emphysema,while none of the Gas group showed the symptom.Conclusion Gasless abdominal wall lift device is safe and simple,resulting in quick recovery without leading to pneumoperitoneum-related complications.

Objective:To study the feasibility of surgical techniques and clinical experience of the airbag-free separation of nail and the whole extraperitoneal laparoscopic hernia repair(TEP).Methods:Ninty-three cases of inguinal hernia.Patients were treatecl in our hospital from March 2005 to January 2009,with 39 cases of regular.Free air and non-stapling of mesh TEP and 54 cases of routine open tension-free hernioplasty.Results:The operation times were as follows:TEP Group,unilateral hernia(101.3?15.6 min),bilateral hernia(138.4?17.3 min);Open Group,unilateral hernia(81.6?7.6 min),bilateral hernia 175.8?22.0 min.The couplications in TEP Goup inclucled 3 cases of retroperitoheal rupture,3 cases of intra-operative vascular injury,and 2 cases of postoperative scrotal hematoma.Nine cases of sacrotal hematoma,4 cases of infective and 6 cases of long-term pain in the groin area happened in open Group.Conclusion:TEP of free balloon separator with no stapling patch is safe,reliable,less post-operative complications and especially suitable for bilateral hernia.

Objective To evaluate the efficacy and safety of facilitated PCI(low-dose rt-PA combined with percutaneous coronary intervention)in acute myocardial infarction(AMI).Methods One hundred and sixteen patients with AMI were divided into low-dose facilitated PCI group(n=69)and direct PCI group(n=47).69 patients in low-dose facilitated PCI group were treated with an intravenous drip of 50 mg rt-PA and PCI,while 47 patients in direct PCI group were treated with PCI.The rates of recanalization before and after PCI,and the left ventricular ejection fraction(LVEF)and major hemorrhage and major adverse cardiac events(MACE)in hospital were compared in two groups.Results There was no significant difference in the interval from hospitalization to the PCI between low-dose facilitated PCI group and direct PCI group.Compared with direct PCI group,the rates of recanalization and TIMI grade 3 before PCI were significantly higher in low-dose facilitated PCI group(44.7% vs 21.7%,P

Objective To investigate the coordinate repression of angiostatin(AS)and Fas gene on human colon carcinoma LOVO.Methods Plasmid pcDNA3-AS and pcDNA3-Fas were constructed,and AS,Fas,AS and Fas gene were transfected to human colon carcinoma LOVO cells by liposome method.The expressions of target protein were detected by Western blot.The effects of transfection of AS and Fas gene on the growth of human colon carcinoma cells were detected by MTr methods.AS,Fas,AS and Fas gene were transfected to the human colon carcinoma subcutaneously implanted in nude mice by direct injection into the tumor.The tumor sizes were detected after 14 days of the first gene transfection.Results The effect of gene transfeetion in LOVO cell after twelve hours,24 h,48 h and 72 h were observed and compared with control group,co-transfection of Fas and AS gene group and Fas group significantly inhibited the growth of human colon carcinoma LOVO line cells(P＜0.01).Fourteen days after plasmid transfection,the tumor volume in group Fas and group co-transfection were signifieandy smaller than that of control,AS and Fas group(P＜0.05).The tumor volume in AS group and Fas group were significantly smaller than that of control(P＜0.05).Conclusion Angiostatin and Fas gene have coordinate repression effect on human colon carcinoma in vivo.

Objective To investigate the value of postprocessing technique of multi-slice helical CT for the occult fracture located in complicated structure. Methods One hundred-thirteen patients with acute trauma but negative on plain X-ray film were reviewed retrospectively. All of the patients underwent MSCT ,and original data were reformed with reconstruction. Results Of one hundred-thirteen injuried patients , fractures were demonstrated with MSCT imaging in forty-eight cases. Conclusion The combination use of axial image of MSCT , reconstruction and post-processing is of high value in definite detection of occult fracture , and play an important role in selecting therapy project and evaluating prognosis.

Objective To investigate the diagnostic significance of endoscopic ultrasonography (EUS) for suspected choledocholithiasis in non-cholangiectasis. Methods EUS was performed on 33 patients with cholecystolithiasis, whose common bile duct diameters were less than 8 mm, with one of the histories of acute pancreatitis, obstructive jaundice or recurrent biliary colic, but without common bile duct stone (CBDS). The results were compared with surgical or ERCP findings. Results Twenty cases in 33 were diagnosed ascholedocholithiasis by EUS. Sixteen of the 20 cases were confirmed as CBDS with further operation or ERCP. Compared with the results of surgery or ERCP, the sensitivity, specificity, positive prediction value and negative prediction value of EUS for choledocholithiasis were 100% , 76. 5% , 80% and 100% respectively. Conclusion EUS is of high diagnostic significance for suspected choledocholithiasis in non-cholangiectasis.

0.05). Conclusions LS,whereas of less traumatic and low morbidity, results in comparable effects as OS for the treatment of ITP.

Objective: To evaluate the impact of anemia on prognosis of elder patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).
Methods: A total of 908 consecutive ACS patients elder than 60 years of age with PCI in our hospital from 2010-06 to 2012-06 were studied. According to WHO deifnition of anemia (HB<12.0 g/dL in female and HB<13.0 g/dL in male), the patients were classiifed as Anemia group, n=283 and Non-anemia group, n=625. The patients were followed-up for 1 year. The basic clinical characteristics, incidences of mortality and major adverse cardiovascular and cerebravascular events (MACCE) were compared between 2 groups by cardiac death, myocardial re-infarction, worsening of cardiac function, target vessel revascularization, cerebral hemorrhage and cerebral infarction.
Results: There were 31%of patients suffering from anemia. Anemia group had more patients with the elder age, female gender, diabetes, hypertension, chronic kidney disease, decreased LVEF, more patients with 3 vessel-disease, and higher mortality at 1 year after PCI, higher rate of MACCE than those in Non-anemia group, all P<0.05. Multiple regression analysis indicated that anemia is the independent predictor for mortality in elder ACS patients at 1 year after PCI, P<0.05.
Conclusion: Anemia may increase the incidences of mortality and MACCE in elder ACS patients after PCI for a long-term.

OBJECTIVETo evaluate the result of laparoscopic colorectomy in treatment of colorectal cancer.

METHODSLaparoscopic colorectal surgery was performed in 78 patients with colorectal cancer. Operative procedures, complications and postoperative recovery were studied.

RESULTNone of the 78 patients died of laparoscopic colorectal surgery or complications. Eleven patients died from tumor metastasis and 2 from other causes. Twenty-one, 17, 8 patients for 1, 3, 5 years survived respectively. In nine patients who had received operation less than 1 year, no tumor recurrence or metastasis was found except in 1 patient 11 months after operation.

CONCLUSIONLaparoscopic colorectal cancer resection is essential to colectomy for colon and rectum cancer when indicated.

Adult ; Aged ; Aged, 80 and over ; Colectomy ; methods ; Colorectal Neoplasms ; mortality ; pathology ; surgery ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Neoplasm Staging ; Rectum ; surgery